2014 Accountability hearing with the Health and Care Professions Council - Health Committee Contents

2  Current regulatory activities

The remit of the HCPC

3.  The HCPC was established by Parliament under the Health and Social Work Professions Order 2001. Its predecessor, the Council for Professions Supplementary to Medicine (CPSM), was established in 1961. The HCPC states that:

    Our main objective is to safeguard the health and wellbeing of persons using or needing the services of our registrants and we do this by:
  • setting and maintaining standards for professional skills and conduct;
  • maintaining a register of professionals who meet these standards;
  • approving and monitoring education programmes leading to registration; and
  • taking action when a registrant's fitness to practise falls below our standards.

    We also protect professional titles, with all the professions having at least one protected title. It is a criminal offence for someone to claim to be registered when they are not, and we take action against those who do so.[4]

4.  The Council is an independent, self-funding organisation. It is regarded as a public body but it is not part of the Department of Health or the NHS. All its operational financial costs are funded by fees from registrants. The fees are set out in the Health Professions Council (Registrations and Fees) Rules 2003 and any fee increase is subject to a consultation and must be approved by the Privy Council. From time to time, grants are received from the Department of Health in relation to specific projects.[5]

5.  In its most recent annual report, the HCPC describes 2012-13 as "a year of significant growth and change", during which, in August 2012, over 88,000 social workers transferred onto their register.[6] Even aside from taking on social workers the HCPC register has been increasing-the HCPC report that, in the five years since 2008, net registrant numbers have risen by 20%, excluding the registrants who transferred from the GSCC.[7]

Breadth of HCPC's role

6.  The HCPC has a broad remit, covering 16 different professions. The Committee asked the HCPC about the implications of this in its oral evidence session. Anna van der Gaag, the Chair of the HCPC, said:

    The key thing here is that we work very closely with a large number of partners who are drawn from the professions themselves, as well as from other disciplines. We have both lay partners and professional partners who work with us on a sessional basis and are involved in the day-to-day decision making of the regulator. They are the ones who handle things right from the registration process, so deciding who comes on to the register, through to visits to universities, so approval and quality assurance of education programmes, and all the fitness-to-practise work that we do. The system could not operate without the expertise of those individuals. Obviously, the recruitment, training and quality assurance processes for those partners are important to how we work. [8]

7.  The HCPC argued that it was more than just 16 sub-regulators joined together:

    From day 1, the organisation was set up where we do the things identically wherever possible; we try to not be different for different professions. In that way I think you get a very efficient regulator. When we started doing that, the reaction of the professional bodies to the idea, for example, that you could have the same sort of standards for the professions was, "How can that possibly work, if at one end of the spectrum you have clinical scientists and at the other end of the spectrum you have arts therapists?" Our view was that you can set up a regulator where you have common processes and systems, and I think we have demonstrated that it really works very efficiently.[9]

8.  Marc Seale, the HCPC's Chief Executive and Registrar, said that in his view the HCPC operated efficiently for three reasons:

    The first is that if you have lots of professions and professional bodies, you tend to try to come up with a degree of consensus, so the extreme views—the very odd ways of doing things—are eliminated and you get a good, solid centre. The second is a technical thing that you avoid regulatory capture by the professions that you are regulating, because one profession does not have that huge influence on the regulator. The third component is that you get economies of scale and therefore you can deliver regulation very effectively as well.[10]

Regulation of social work

9.  In August 2012, over 88,000 social workers transferred onto the HCPC's register.[11] The PSA argue that the HCPC's performance in 2012-13 was particularly notable given that it completed this transfer within this period.[12] Social workers in England now account for 26.8% of the HCPC's register, and 44.3% of its total Fitness to Practise cases; 0.88% of registered social workers were subject to concerns.[13]

10.  Anna van der Gaag described the steps that had been taken to prepare for taking on this new responsibility:

    Certainly in terms of our own governance, we have been very fortunate. We have a social worker on the governing council, so clearly we get expertise at a strategic, oversight level. In terms of having the right expertise in the right place at the right time, we have an established record on engagement and communication, and on making sure that, where we need expertise, we seek it out. We make no pretence of knowing about social work practice, but we make sure that we bring in experts from the field and recruit them as our partners, as Marc has said. If we have to develop standards, we make sure that we have people from all elements and areas of the profession involved in that process.[14]

11.  When asked about how the HCPC handles the arguably more subjective nature of judgements in social work when compared to some other clinical professions, Dr van der Gaag responded as follows:

    I think that that is an important point. I do see that there will be circumstances in which there will be much clearer objective parameters around a judgment, and others where the nature of the relationship—how it is interpreted and how it is understood—will be very difficult, because there will often be diametrically opposed views on that relationship. That certainly is the case in social work practice, and we would be very aware of it. I think it would also be the case in other disciplines—perhaps not to the same extent, but certainly in psychology, occupational therapy, speech and language therapy, and arts therapy—that there would be those perhaps more subjective elements and judgments to be made.[15]

The assessment of the Professional Standards Authority

12.  In their written submission to the Committee, the PSA report that:

    In 2012/2013 the HCPC met all our standards of good regulation. This demonstrated an improvement on 2011/2012 where we found that the HPC (as it was at the time) was not meeting the third standard of good regulation for education and training.

    We consider that the HCPC's performance in 2012/2013 is particularly notable as it completed the transfer of the register of social workers in England during this period. This added over 80,000 registrants to the HCPC registers, making it the second largest regulator in the health and care professions sector in the UK.

    Despite the considerable additional work involved in preparing for and implementing the transfer of the regulation of social workers in England, the HCPC has maintained its efficient and effective performance across all areas of responsibility. This noteworthy given the increase in the volume of allegations it is handling and the expansion of its scope.[16]

13.  The PSA's written evidence highlights findings from an audit carried out in June 2013 of 100 cases that the HCPC closed in the initial stages of its FtP investigation process, which is part of the PSA's regular three-year cycle of risk-based auditing. The PSA provide the following summary of this year's audit of the HCPC:

    In our previous audit of the initial stages of the HPC's FtP processes, published in February 2010, we found that they dealt with cases 'efficiently and effectively' and that 'the vast majority of decisions taken on cases were reasonable and protected the public'.

    Our conclusion from our 2013 audit was that the general case work system operated by the HCPC demonstrates that public protection is maintained. We identified a number of examples of good practise, specifically around active case management and progression of cases.

    However we found areas for improvement in 53 of the 100 cases we audited, including 25 cases where we had concerns about decision making and six cases where we considered there were potential implications for public protection and/or maintaining public confidence in the professions or the system of regulation. The HCPC has outlined actions to address the areas of concern we highlighted in report.[17]

14.  At the Committee's evidence session with the PSA in July 2013, the PSA raised the issue of health assessments for registrants who had drink or drugs related convictions.[18] Further detail is provided in the PSA Annual Performance Review Report:

    The HCPC commissioned research in August 2012 into the concepts of public protection and impairment of a registrant's fitness to practise in relation to ill health. This was in response to our earlier recommendation that regulators should routinely request a health assessment for all registrants who are convicted of a drug or drink-related offence. Following the consideration of the results of the research in February 2013 the HCPC concluded that it will continue with its approach of not routinely requesting a health assessment in such cases but considering it on a case-by-case basis. We are disappointed by this as we note that other regulators have found that investigating convictions and cautions involving drugs and alcohol has led to identifying an underlying health and performance concern in the registrant which might otherwise not have been apparent. However we note that the HCPC's decision is based on evidence which it has assessed. We will continue to keep this issue under review.[19]

15.  Responding to a question about this in oral evidence, the HCPC explained their position:

    First, we very much agree with the PSA on the seriousness of drink and drug-related offences. The issue for us is more about how we deal with those cases. Our assertion is that each case should be looked at individually: the circumstances surrounding drink-driving, for example, can be very different for different registrants and therefore the case-by-case approach that we take is, we think, fair, proportionate and appropriate for those on our register.

    Having said that, we have set out clear criteria in our guidance on where a drink or drug-related offence will be taken through to an investigation stage—for example, if it is a repeat offence; if the offence occurs during the course of the registrant carrying out professional duties; if there is any sense that there were aggravating circumstances, such as a failure to provide a specimen or failure to co-operate with the police; or if the penalty imposed exceeds the maximum mandatory disqualification. We have those four criteria that automatically lead to further investigation, but we must be absolutely clear on whether the actual incident has an impact on fitness to practise. There are instances where that is not the case, so to take a blanket approach, in our view, is not the right approach.[20]


16.  The Committee received evidence from two organisations representing professions that are regulated by the HCPC-the Chartered Society of Physiotherapy, which represents 52,000 physiotherapists, physiotherapy students, and support workers, and the Association of Educational Psychologists, which represents 2,750 Educational Psychologists registered with the HCPC. The Association of Educational Psychologists outlines a number of concerns about the HCPC's Fitness to Practise process. These include feedback that "in some cases investigations are not carried out thoroughly" and "Fitness to Practise issues are dealt with inconsistently". They also raise concerns that "within the HCPC there is only a partial understanding of the work of educational psychologists" and "apparently high staff turnover". The information was compiled by the Association of Education Psychologists on the basis of feedback from members.[21]

17.  The Chartered Society of Physiotherapy (CSP) reports that it believes "that the HCPC is an effective regulator, which takes a proportionate approach and provides a sound regulatory framework for physiotherapy and other Allied Health Professionals. The model of being a regulator of a large number of professions is one that works well, with distinct advantages, deriving from its cross-professional approach, which are strongly in the public interest".[22] However, the CSP does highlight "certain areas for improvement" in fitness to practise arrangements, including a need to bring down waiting times, and concerns that the initial investigation process is not always sufficiently robust, leading to potential difficulties at fitness to practise hearings.[23]

Time taken to conclude Fitness to Practise hearings

18.  The HCPC wrote to us following the accountability hearing, providing further information about the time taken to conclude their Fitness to Practise hearings:

    In 2012-13 the length of time taken for a matter to be considered by an Investigating Committee Panel from the standard of acceptance being met is a mean of six months and a median of four months. For those cases which were referred to a final hearing, the mean and median average from receipt of allegation to consideration by an Investigating Committee Panel was seven and five months respectively.

    In 2012-13 the total length of time for a case to conclude from receipt of allegation to conclusion at final hearing was a mean average of 16 months and a median average of 14 months. 27 cases took in excess of 24 months from receipt of allegation. The mean and median length of time from the date of the Investigating Committee Panel to conclusion at final hearing was a mean average of nine months and a median average of eight months.

    In 2012-13, the total length of time to close all cases from the point a case was received to case closure at different points (closure without consideration by an investigating committee panel, closure by an investigating committee panel, closure at final hearing) was a mean average of nine months and a median average of six months.[24]

19.  The PSA have reported to us that in 2012-13 the HCPC met all its standards of good regulation. It also stated that "the HCPC has maintained its efficient and effective performance across all areas of responsibility." The PSA consider that the HCPC's performance in 2012-13 is particularly notable as it has completed the transfer of social workers during this period, increasing the volume of allegations it is handling, and expanding its scope.

20.  The PSA has highlighted the specific issue of routine health checks for registrants who are convicted of drink or drug related offences. The HCPC has argued that rather than introducing a blanket policy of health checks, a case-by-case approach is more proportionate. We will revisit this issue next year.

21.  Evidence we received from organisations representing professions registered by the HCPC also raised some specific concerns about the HCPC's fitness to practise processes. We recommend that the HCPC consider the individual points raised in written evidence by these organisations, and provide a response to those organisations, to ensure that their feedback is used, where necessary, to improve processes.

22.  We asked the HCPC to provide us with further information on the length of time it takes to conclude fitness to practise cases. The HCPC reported to us that in 2012-13 the average total length of time to close all cases was 9 months; the average length of time to conclude cases that went through to a final hearing was 16 months. However, reporting 'average' timescales can conceal wide variations and certain cases taking an unacceptably long time to resolve-indeed the HCPC report that in 2012-13, 27 cases took in excess of 24 months to conclude. We urge the HCPC to commit itself to a clear "start to end" target setting out the maximum length of time it takes to conclude its Fitness to Practise processes, and in our view the maximum time should be 12 months. Such a target represents a commitment from the HCPC to the patients and service users it aims to protect, and to its registrants, and should be clearly communicated on its website.

Revalidation or 'continuing fitness to practise'

23.  The HCPC's written evidence outlines on-going work in the area of revalidation. It uses the term "continuing fitness to practise" instead of revalidation, to describe the steps taken by regulators (and others) to support fitness to practise beyond the point of initial registration:

    Since 2003, we have required registrants to renew their registration every two years. Since 2006, registrants have had a compulsory, statutory requirement to undertake continuing professional development (CPD). Our standards for CPD are focused on outcomes-the benefits of CPD to services users and quality of care. These standards are linked to registration and are underpinned by random audits. We consider that auditing is a proportionate method of ensuring compliance. We can and do remove individuals from the Register where our standards have not been met. We also have in place requirements for those seeking to return to the Register after a period out of practise.

    Analysis of fitness to practise allegations against registrants has shown that the majority of cases (72% in 2012-13) are about conduct and professionalism with relatively few cases purely about lack of competence. We have been undertaking a programme of work and research to build the evidence base further and inform decisions about how we approach the assessment of continuing fitness to practise.

    This has included or includes the following.
    • Research (2011) looking at perceptions of professionalism by both students and educators and about why and how professionalism and lack of professionalism may be identified. A further study is on-going looking at methods for measuring and tracking professionalism during training and beyond.
    • Research (2011) looking at the potential value of service user and colleague feedback tools to provide further external input on registrants continuing fitness to practise.
    • More in-depth analysis of existing fitness to practise data (2012) to look at the characteristics of registrants reaching final hearings and whether there are relationships with variables such as age, gender, work setting and route to registration which might suggest clear patterns of risk.
    • More in-depth analysis of the content, outcomes and impact of the CPD standards and audits since 2006, including, for example, the extent to which annual appraisals and service user feedback form part of registrants' existing CPD portfolios.

    We anticipate that the outcomes of these pieces of work will inform whether and in what ways we might enhance our existing approach to assessing registrants continuing fitness to practise. For example, we might consider requiring registrants to seek service user feedback to inform their learning and we might want to consider whether we have sufficient information on risk such that we might consider targeting our audits towards 'higher risk' groups. We consider that it is important that any further developments in this area are evidence-based and proportionate.[25]

24.  Dr van der Gaag gave further information about the HCPC's approach to continuing fitness to practise in oral evidence:

    We have had the system in place since 2006 and we ask our registrants to keep up to date; to keep a record of their continuing professional development activities; and to make sure that these activities benefit patients and service users and have an impact on the quality of what they do. Those are the clear and simple messages that we give to registrants. Those are mandatory standards that have been in place since 2006.

    Since 2008, we have been auditing a proportion of those on the register to ensure compliance. If they are selected for audit, they have to submit evidence to us, which is assessed by trained assessors working in pairs. They make a judgment about whether the profile is meeting the standards that we set. To date, we have audited about 11,500 individuals, of which a very small proportion have been removed from the register because they have failed to meet the standards: 0.7% have been removed from the register and a further 4% have voluntarily deregistered—having been selected for audit, they have disengaged from the process. We have now audited all the professions except social workers, who have just recently come into regulation by HCPC, and some of them are now in the second round of audits. In terms of compliance, the numbers are pretty consistent across the 15 professions that we regulate. The system is there to assess compliance....

    ...We emphasised the outcomes-focused approach, which is about how continuing professional development activity benefits service users and patients. It is about outcomes, not the amount of activity undertaken. We also strongly emphasised that reflection on practice—keeping a reflective diary and thinking about the impact of learning activities on professional practice—was a key element of the process.

    We have been advocating the outcomes-focused approach, the reflective approach, for the past six to seven years. It has taken time to convince some of the professions of its value, but the feedback we get now is that they recognise that the reflective process and the outcomes-based approach add value and are a more motivating force than a points system or an hours-based approach to continuing professional development. We certainly want to do more research—for example, into the impact of work setting on CPD activity. We also want to look at differentials between the professions—at the moment we do not see any great differentials in terms of pass/fail, but we have more work that we want to do in that respect.[26]

25.  When asked whether they planned to include patient feedback within their system of continuing fitness to practise, and what challenges might be associated with doing that across 16 different professions, Dr van der Gaag told us that:

    A large number of our registrants, when they submit their profiles to us, already include patient feedback as one of the elements—one of the pieces of evidence. That is something that they are already doing, and they have been doing it since the first audits began in 2008.[27]

26.  They then argued that there was no 'one size fits all' solution in relation to patient feedback tools:

    .... If you want to receive authentic and valuable feedback from, say, somebody with a learning disability, somebody who has had a stroke, or perhaps a young person who is coming to use mental health services, you need different tools. The work that we are doing now is around looking at the different types of tools that have been developed and validated with different client groups, rather than saying to our registrants, "We want you to use one tool," which we believe will be, in the end, a blunt instrument and will not say very much about the person's view of the practitioner.

    ...These tools are much better used as developmental assessments—so "formative" tools, in the language of the report, rather than summative tools, which in a sense are a yes or a no on performance. They are much better used when they are part of a much more comprehensive feedback on a health professional's performance. So, again, we are taking note of that research and looking for a variety of ways of involving patients and service users in giving feedback to our registrants. We don't think there is a one size fits all.[28]

27.  The HCPC told us that there is no one-size-fits all solution to securing patient input into their continuing fitness to practise processes. In our view this should constitute an important part of any revalidation system, and we urge the HCPC to continue their efforts to include such feedback on a regular and consistent basis.

The Francis report

28.  As the Committee set out last year in its report After Francis: Making a Difference, healthcare professionals have an unambiguous professional duty to raise with the relevant authorities any concerns which they have about the safety and quality of care being delivered to patients, and the Francis Report has implications for all professional regulators:

    The Francis Report demonstrated that failure of professional responsibility was a key factor which contributed to failures of care at the Mid Staffordshire NHS Trust. The Committee has also constantly emphasised the importance of an open and accountable professional culture in its own reports during this Parliament.[29]

29.  The HCPC's annual report gives the following overview of the impact of the Francis report on their organisation:

    In February 2013 the report of the Public Inquiry into failings in care at the Mid-Staffordshire NHS Foundation Trust was published. We have begun to consider carefully what action we might take to implement the report's recommendations. For example, as part of our review of the standards of conduct, performance and ethics we will want to strengthen our requirements for registrants around reporting and escalating concerns about poor practice. The work of the Inquiry will be of importance to us on many levels, and we are looking at our own culture as well as at our regulatory functions to see what changes we might make to ensure that we are also putting patients and service users first in all we do.[30]

30.  In their evidence to the Committee, the PSA discuss the implications of the Francis report for the HCPC:

    The Francis Inquiry has thrown a spotlight on the effectiveness of regulatory and supervisory organisations, both individually and as part of a wider safety and quality structure. One of the key lessons from this Inquiry, and the Government's response, is that a regulator's effectiveness should be gauged on its contribution to the achievement of the common goal of safe, high-quality care, as well as on its fulfilment of particular and focused statutory duties.

    The HCPC have perhaps a greater challenge than other professional regulators in this respect, due to the breadth of their register with 16 different professions operating across a variety of settings. The efficiency and effectiveness with which it meets own statutory responsibilities is commendable. However, in the future, regulators will also be judged by the extent to which they work with others as part of the safety and quality architecture of health and social care, for the benefit of patients, service users and the wider public. This will require a more coordinated approach and the Committee may wish to understand how the HCPC plans to cooperate and collaborate with other organisations in the future to achieve common regulatory outcomes.[31]

31.  The HCPC's written evidence describes how they work jointly with other regulators:

    In order to carry out our regulatory functions effectively we work with relevant organisations, sharing appropriate information relating to registration and fitness to practise. One way we do this is through memoranda of understanding and such agreements are in place with a range of organisations including the Care Quality Commission (CQC) and the regulators of social workers in Northern Ireland, Scotland and Wales.[32]

32.  We asked the HCPC whether Memoranda of Understanding were sufficient. Marc Seale told us:

    In my view MOUs are, frankly, interesting bits of paper, but what you have to be concerned about is what is happening on an operational level within the regulators. When something comes up—for example, if we get a complaint against a medic arriving at our door—do we do something about it and is that information going across to other regulators? I think MOUs are a fig leaf in terms of what we are doing. I also think that there is a tendency—I have seen it from the Shipman inquiry and various things—to say, "Oh, we are having meetings. The chief executives are getting together and we do this once a month." There is a lot of enthusiasm at the first and second meetings, but gradually that disappears. What you have to do, and what we as the regulator try to do, is to make those contacts with other regulators. For example, we have picked up cases from other regulators—for example in the US—that have been in contact with us because we have had an individual on our register. The person came off our register and then went off to the US and did something totally inappropriate. Someone then said, "Actually, they have now gone back to the UK," so those organisations phone us up and make contact, because we know them.

    To me, it is about personal contact, building up that trust, and making sure that other regulators and organisations know about your existence so that the information comes across to you. Having meetings and MOUs is not going to achieve that.[33]

33.  When asked what difference being a multi-professional regulator made to linking in with different organisations, Marc Seale argued that, if anything, it made it easier, because they have "a bigger presence, so people are more likely to know about us."[34] Dr van der Gaag added that

    We invest hugely in communication and engagement. We see that as an absolutely essential part of what we do. In terms of the professions that we regulate, we have an open-door policy. If they want to contact us about anything at all, or raise concerns with us that are perhaps at a macro level, we are there. We have regular meetings, at all levels of the organisation, with officers.

    Equally, we need to be in touch with organisations that are there to represent patients and service users. One initiative that has come out of Francis is work that we are doing at the moment with the Patients Association, where it is reviewing our complaints processes. There will be huge learning from that. It has set standards on complaints, and we want to know whether we meet those standards and in what way could we improve from the association's perspective. Obviously, our hope is that, by going through that scrutiny process—we are the first regulator to do so—there will be learning that we can share with our colleagues in the other professional regulatory bodies. [35]

34.  In November 2013, the HCPC published the results of research it has carried out with the public:

    The Health and Care Professions Council (HCPC) is launching new research today which finds that a fifth of UK adults have encountered behaviour from a health or care professional that made them doubt their fitness to practise.

    More than a quarter said the health or care professional in question seriously or persistently failed to meet standards whilst 16 per cent said they felt the professional failed to respect the rights of a patient to make their own choices. Thirteen per cent felt they were 'hiding mistakes' and a further nine per cent felt they were exploiting vulnerable patients. One in twenty said they had experienced or witnessed reckless or deliberately harmful acts.

    Despite these figures, just three out of ten reported their concerns, with a further 73 per cent of adults who would not know where to go to report concerning behaviour.

    The data, released today supports research commissioned by the HCPC earlier in the year into what the general public feel they need protection from most. Findings from this report show that Illegal drug taking and shoplifting were far more likely to concern members of the public than convictions for drink driving. Dishonesty and fraud were also key concerns for most.[36]

35.  Anna van der Gaag gave more information about this work in the Committee's oral evidence session, arguing that although general awareness of regulators may be low, once people want to make a complaint to the HCPC, they find navigating their way through the system easier:

    That is in fact one piece of work in quite a long line of polling initiatives that we have commissioned or undertaken over the years to try to gauge the public's understanding of professional regulation, what it is there to do and how to access it. All those reports say the same thing, which is that there is a low level of awareness about this in general. Crucially, however, there is also a clear steer that, once people need to know where to go to make a complaint, they find it a much easier route. General awareness is low, but once someone needs to make a complaint they very quickly can either use the internet or find out through their GP, their pharmacy or a number of other mechanisms, where to come to make a complaint. It is about the general awareness versus the specific route to making a complaint or raising a concern. That was what the research was focusing on.[37]

36.  Dr van der Gaag said that there was nevertheless no room for complacency on this issue:

    There is never any sense with us that we are content. Of course, it would be better if there was a more general awareness. Of course, it is important to make ourselves accessible by, for example, looking at our language, both written and what we put on the website, and making sure that there is literature published in easy-read formats and in other languages. We are doing that already but there is a lot more that we can still do to make sure that we are accessible and that people can then contact us and follow through with raising concerns. We would not be in any way complacent about that. We are aware that this lack of consciousness is a general issue for regulators.[38]

37.  Marc Seale also said that powers within the HCPC's legislation provide a useful means for the HCPC to investigate complaints which have been raised with them, but which a registrant may not wish to pursue further:

    We have a power in our legislation called the 22(6) that enables myself as the registrar to make the complaint. For example, if there are two biomedical scientists, and one of them has concerns about the other who is working in the same laboratory, but feels very uncomfortable about making the complaint themselves, if they contact us, give us the right information and say, "Look, I really don't want to go to the next stage," I, as the registrar, make the allegation or complaint. That is a very efficient way of dealing with this issue about, "Hang on, you are not actually going to pick those ones up." It is a simple bit of legislation, but it works very effectively.[39]

38.  The Francis report has thrown a spotlight on the role of health and care regulators in ensuring public protection, as healthcare professionals have an unambiguous professional duty to raise with the relevant authorities any concerns which they have about the safety and quality of care being delivered to patients. For the effective regulation of clinical and caring professions, regulators need to be visible and accessible to registrants, and also to patients and members of the public who wish to raise concerns about patient safety. Regulatory bodies must also collaborate effectively between themselves. We recommend that the HCPC continues to monitor its own profile both with patients and service users, with professionals, and with other relevant organisations, and we will seek further evidence of the progress the HCPC and other professional regulators have made in implementing the recommendations of the Francis report at our next accountability hearings in the autumn.

4   HCPC (HCPC 0001), paras 2.3-2.5 Back

5   HCPC, Annual Report and Accounts 2012-13, p4 Back

6   HCPC, Annual Report and Accounts 2012-13, p3 Back

7   HCPC, Annual Report and Accounts 2012-13, p5 Back

8   Q2 Back

9   Q3 Back

10   Q3 Back

11   HCPC, Annual Report and Accounts 2012-13, p3 Back

12   Professional Standards Authority, (HCP 0002) para 2.2 Back

13   HCPC, Fitness to Practise Annual Report 2013, p13 Back

14   Q21 Back

15   Q22 Back

16   Professional Standards Authority, (HCP 0002) para 2.1-2.3 Back

17   Professional Standards Authority, (HCP 0002), paras 3.2 - 3.4 Back

18   Oral evidence taken on 9 July 2013, HC 528-I, qq7-9 Back

19   Professional Standards Authority, Annual Report and Accounts and Performance Review Report 2012-13, p 83, para 16.36 Back

20   Q8 Back

21   Association of Educational Psychologists (HCP 0008), paras 3-9 Back

22   Chartered Society of Physiotherapy, (HCP 0009), summary, p1 Back

23   Chartered Society of Physiotherapy, (HCP 0009), para 2.6 Back

24   HCPC supplementary evidence (HCP 0013) pp 4.5-4.7 Back

25   HCPC (HCPC 0001)paras 4.1 - 4.5 Back

26   Q10 Back

27   Q13 Back

28   Q13 Back

29   Health Committee, Third Report of Session 2013-14, After Francis - Making a Difference, HC 657, para 16-17 Back

30   HCPC, Annual Report and Accounts 2012-13, p3 Back

31   Professional Standards Authority, (HCP 0002) paras 5.1 - 5.2 Back

32   HCPC (HCP 0001), para 2.6 Back

33   Q18 Back

34   Q19 Back

35   Q19 Back

36   HCPC launches new research and takes steps to protect the public, HCPC press release, 20 November 2013  Back

37   Q16 Back

38   Q17 Back

39   Q17 Back

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